Basic Information
Provider Information
NPI: 1710487012
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: ZACHARY
MiddleName: N.
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1225 E WEISGARBER RD STE 200
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379092675
CountryCode: US
TelephoneNumber: 8655844747
FaxNumber:  
Practice Location
Address1: 9333 PARK WEST BLVD STE 102
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379234305
CountryCode: US
TelephoneNumber: 8654702696
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/14/2018
LastUpdateDate: 02/14/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X11672TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home